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Age as a risk factor in vasculitis.

Andrea D Gloor1, Gerald J Berry2, Jorg J Goronzy1,3

  • 1Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.

Seminars in Immunopathology
|February 10, 2022
PubMed
Summary
This summary is machine-generated.

Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are large vessel vasculitides influenced by host age. Immunosenescence, or immune system aging, impairs CD8+ T cell function, increasing GCA risk.

Keywords:
CD8+ Treg cellsGiant cell arteritisImmunosenescenceInflammagingNOTCHTakayasu arteritismTOR

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Area of Science:

  • Immunology
  • Vascular Biology
  • Rheumatology

Background:

  • Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are autoimmune diseases affecting the aorta and its branches.
  • Host age is a critical risk factor for both GCA and TAK.
  • TAK affects younger individuals (2nd-4th decades), while GCA primarily affects older individuals (peak 8th decade).

Purpose of the Study:

  • To review the impact of immunosenescence on GCA risk.
  • To explore how age-related immune system differences influence the distinct immunopathology of TAK and GCA.

Main Methods:

  • Review of current evidence on immunosenescence and large vessel vasculitis.
  • Comparative analysis of immune cell infiltration and function in TAK and GCA.
  • Focus on the role of CD8+ T cells in GCA pathogenesis.

Main Results:

  • Both GCA and TAK involve macrophage and T cell infiltration, granulomatous inflammation, and vascular remodeling.
  • In GCA, immunosenescence leads to impaired CD8+ T cell function, with reduced effector cells and impaired regulatory T cells.
  • These age-related immune deficits are not observed in TAK, suggesting distinct age-dependent pathogenic mechanisms.

Conclusions:

  • Immunosenescence significantly impacts GCA risk and pathogenesis.
  • Differences in the age of the immune system between TAK and GCA patients contribute to their distinct granulomatous immunopathology.
  • Understanding these age-related immune differences is crucial for differentiating and potentially treating these vasculitides.